Week 7 Test
A 40-year-old patient is diagnosed with early Huntington's disease (HD). When teaching the patient, spouse, and children about this disorder, the nurse will provide information about the a. use of levodopa-carbidopa (Sinemet) to help reduce HD symptoms. b. prophylactic antibiotics to decrease the risk for aspiration pneumonia. c. option of genetic testing for the patient's children to determine their own HD risks. d. lifestyle changes of improved nutrition and exercise that delay disease progression.
C. Genetic testing is available to determine whether an asymptomatic individual has the HD gene. The patient and family should be informed of the benefits and problems associated with genetic testing. Sinemet will increase symptoms of HD because HD involves an increase in dopamine. Antibiotic therapy will not reduce the risk for aspiration. There are no effective treatments or lifestyle changes that delay the progression of symptoms in HD.
A client with advanced ALS is admitted to the hospital. Because of manifestations that are common in clients with ALS, the nurse should a. attempt to institute bowel-training activities. b. provide the client with small, frequent feedings. c. obtain an order for intermittent catheterization. d. orient the client to his or her surroundings frequently.
B (The course of the disease is relentlessly progressive. Cognition, as well as bowel and bladder sphincters, remains intact. The client may be malnourished because of dysphagia. Encourage small, frequent, high-nutrient feedings. The nurse should assess for aspiration and choking. A feeding tube may be considered during the course of the illness. DIF: Application/Applying REF: p. 1919 OBJ: Intervention MSC: Physiological Integrity Basic Care and Comfort-Nutrition and Oral Hydration)
A patient with Huntington disease has just been admitted to a long-term care facility. The charge nurse is creating a care plan for this patient. Nutritional management for a patient with Huntington disease should be informed by what principle? A)The patient is likely to have an increased appetite. B)The patient is likely to required enzyme supplements. C)The patient will likely require a clear liquid diet. D)The patient will benefit from a low-protein diet.
A (Feedback: Due to the continuous involuntary movements, patients will have a ravenous appetite. Despite this ravenous appetite, patients usually become emaciated and exhausted. As the disease progresses, patients experience difficulty in swallowing and thin liquids should be avoided. Protein will not be limited with this disease. Enzyme supplements are not normally required.)
A patient with suspected Parkinson's disease is initially being assessed by the nurse. When is the best time to assess for the presence of a tremor? A)When the patient is resting B)When the patient is ambulating C)When the patient is preparing his or her meal tray to eat D)When the patient is participating in occupational therapy
A (Feedback: The tremor is present while the patient is at rest; it increases when the patient is walking, concentrating, or feeling anxious. Resting tremor characteristically disappears with purposeful movement, but is evident when the extremities are motionless. Consequently, the nurse should assess for the presence of a tremor when the patient is not performing deliberate actions.)
A family member of a patient diagnosed with Huntington disease calls you at the clinic. She is requesting help from the Huntington's Disease Society of America. What kind of help can this patient and family receive from this organization? Select all that apply. A)Information about this disease B)Referrals C)Public education D)Individual assessments E)Appraisals of research studies
A, B, C (Feedback: The Huntington's Disease Society of America helps patients and families by providing information, referrals, family and public education, and support for research. It does not provide individual assessments or appraisals of individual research studies.)
A patient with a new diagnosis of amyotrophic lateral sclerosis (ALS) is overwhelmed by his diagnosis and the known complications of the disease. How can the patient best make known his wishes for care as his disease progresses? A)Prepare an advance directive. B)Designate a most responsible physician (MRP) early in the course of the disease. C)Collaborate with representatives from the Amyotrophic Lateral Sclerosis Association. D)Ensure that witnesses are present when he provides instruction.
A (Feedback: Patients with ALS are encouraged to complete an advance directive or "living will" to preserve their autonomy in decision making. None of the other listed actions constitutes a legally binding statement of end-of-life care.)
The nurse caring for a patient diagnosed with Parkinson's disease has prepared a plan of care that would include what goal? A)Promoting effective communication B)Controlling diarrhea C)Preventing cognitive decline D)Managing choreiform movements
A (Feedback: The goals for the patient may include improving functional mobility, maintaining independence in ADLs, achieving adequate bowel elimination, attaining and maintaining acceptable nutritional status, achieving effective communication, and developing positive coping mechanisms. Constipation is more likely than diarrhea and cognition largely remains intact. Choreiform movements are related to Huntington disease.)
A client tells the nurse that he is experiencing some leg stiffness when walking and slowness when performing ADLs. Occasionally he has noted slight tremors in his hands at rest. This information leads the nurse to suspect a.amyotrophic lateral sclerosis (ALS). b.Huntington's disease. c.myasthenia gravis (MG). d.Parkinson's disease (PD).
D (Early in PD the client may notice a slight slowing in the ability to perform ADLs. A general feeling of stiffness may be noticed, along with mild, diffuse muscular pain. Tremor is a common early manifestation that usually occurs in one of the upper limbs. DIF: Analysis/Analyzing REF: p. 19 MSC: Physiological Integrity Physiological Adaptation-Pathophysiology)
A 62-year-old patient who has Parkinson's disease is taking bromocriptine (Parlodel). Which information obtained by the nurse may indicate a need for a decrease in the dose? a. The patient has a chronic dry cough. b. The patient has four loose stools in a day. c. The patient develops a deep vein thrombosis. d. The patient's blood pressure is 92/52 mm Hg.
D. Hypotension is an adverse effect of bromocriptine, and the nurse should check with the health care provider before giving the medication. Diarrhea, cough, and deep vein thrombosis are not associated with bromocriptine use.
A 63-year-old male patient has just been diagnosed with Parkinson's disease. The nurse is teaching the patient and his family about dietary practices related to Parkinson's disease. What risk is a priority for the nurse to address? A) Fluid overload and drooling. B) Aspiration and anorexia. C) Choking and diarrhea. D) Dysphagia and constipation.
D (Eating problems associated with Parkinson's disease include aspiration, choking, constipa-tion, and dysphagia. Option A is incorrect since fluid overload isn't specifically related to Parkinson's disease and, although drooling occurs with Parkinson's disease, it doesn't take priority. Anorexia (option B) and diarrhea (option C) aren't specifically associated with Par-kinson's disease.)
The nurse is caring for a patient with Huntington disease who has been admitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the patient's plan of care? A)Firmly redirect the patient's head when feeding. B)Administer phenothiazines after each meal as ordered. C)Encourage the patient to keep his or her feeding area clean. D)Apply deep, gentle pressure around the patient's mouth to aid swallowing.
(Feedback: Nursing interventions for a patient who has inadequate nutritional intake should include the following: Apply deep gentle pressure around the patient's mouth to assist with swallowing, and administer phenothiazines prior to the patient's meal as ordered. The nurse should disregard the mess of the feeding area and treat the person with dignity. Stiffness and turning away by the patient during feeding are uncontrollable choreiform movements and should not be interrupted.)
Nursing activities for a client with ALS and family include helping them a. decide on an acceptable level of care early in the course of the disease. b. determine if they want to share the diagnosis to allow genetic testing. c. incorporate nonpharmacologic pain control techniques in the plan of care. d. plan for extensive rehabilitation after exacerbations.
A (Disease management in ALS includes topics such as tube feedings and mechanical ventilation. Planning for an acceptable level of care should begin early in the disease, before a crisis occurs. Of course, decisions should be re-evaluated occasionally as the client's wishes may changes with their experiences with the disease. ALS is not a genetically-acquired disorder. Pain control is usually not an issue in the disease, and as the disease is relentlessly progressive (rather than characterized by remissions and exacerbations), extensive rehabilitation is not utilized. DIF: Application/Applying REF: p. 1919 OBJ: Intervention MSC: Psychosocial Integrity Coping and Adaptation-End of Life Care)
An older adult has encouraged her husband to visit their primary care provider, stating that she is concerned that he may have Parkinson's disease. Which of the wife's descriptions of her husband's health and function is most suggestive of Parkinson's disease? A)"Lately he seems to move far more slowly than he ever has in the past." B)"He often complains that his joints are terribly stiff when he wakes up in the morning." C)"He's forgotten the names of some people that we've known for years." D)"He's losing weight even though he has a ravenous appetite."
A (Feedback: Parkinson's disease is characterized by bradykinesia. It does not manifest as memory loss, increased appetite, or joint stiffness.)
The nurse instructs a group of nursing students that the pathologic changes that occur in the brain of a person with dementia of Alzheimer's disease include a.abnormal accumulation of proteins. b.damage to the myelin sheath of neurons. c.destruction of neurons. d.increase in production of cerebrospinal fluid (CSF).
A (The neuritic plaque is a cluster of degenerating nerve terminals, both dendritic and axonal, that contains amyloid protein. DIF: Comprehension/Understanding REF: p. 1894 OBJ: Intervention MSC: Physiological Integrity Physiological Adaptation-Pathophysiology)
Important self-care measures a nurse can teach a client with Parkinson's disease in order to prevent contractures and improve mobility include which of the following? (Select all that apply.) a. Bend over with your head over your toes to get out of chairs. b. Exercise first thing in the morning. c. Keep a narrow-based gait. d. Look up when you walk, not down at the floor. e. Use a firm surface, like the floor, for exercising.
A, B, D (Clients with PD need to maintain mobility and prevent contractures. Options a, b, and d are important self-help measures. The client should use a wide-based gait. If it is too hard to get on the floor to exercise, the client should do exercises in bed. DIF: Application/Applying REF: p. 1906 OBJ: Intervention MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Self Care)
To assist the client with Parkinson's disease to reduce tremor, the nurse suggests that the client a.clasp arms about self and squeeze. b.sleep on the non-tremorous side. c.tightly hold change in the pocket. d.visualize stilling the tremor.
C (Clasping change tightly in the pocket, using both hands to complete tasks, and sleeping on the tremorous side will help lessen the tremor. DIF: Application/Applying REF: pp. 1905, 1906 OBJ: Intervention MSC: Physiological Integrity Physiological Adaptation-Illness Management)
The nurse cautions clients with ALS and their families to be aware that (Select all that apply) a. activities should be spaced throughout the day. b. clients experience incontinence, an early cause of falling. c. cognition will usually decline late in the disease. d. muscle weakness may cause a risk for injury.
A, D (Safety is a prime concern with ALS (and with any degenerative neurologic disorder). Muscle weakness is progressive, leading to increased risk of falls. Some interventions to prevent this include spacing activities throughout the day, conserving energy, avoiding extremes of hot and cold, and using assistive devices such as canes or wheelchairs. Clients with ALS usually do not experience incontinence and cognition remains intact for the duration of the disorder. DIF: Application/Applying REF: pp. 1918-1919 OBJ: Intervention MSC: Safe, Effective Care Environment Safety and Infection Control-Injury Prevention)
A 64-year-old patient who has amyotrophic lateral sclerosis (ALS) is hospitalized with pneumonia. Which nursing action will be included in the plan of care? a. Assist with active range of motion (ROM). b. Observe for agitation and paranoia. c. Give muscle relaxants as needed to reduce spasms. d. Use simple words and phrases to explain procedures.
A. ALS causes progressive muscle weakness, but assisting the patient to perform active ROM will help maintain strength as long as possible. Psychotic manifestations such as agitation and paranoia are not associated with ALS. Cognitive function is not affected by ALS, and the patient's ability to understand procedures will not be impaired. Muscle relaxants will further increase muscle weakness and depress respirations.
To prevent complications caused by a common problem of Huntington's disease, the nurse should a. institute seizure precautions. b. pad wheelchairs and beds. c. start an exercise regimen. d. teach different communication signals.
B (Excessive movements and falling can cause injury in the client with Huntington's disease. Interventions include padding wheelchairs and beds, providing shin guards, and using gait belts for ambulation. Communication does become difficult and alternative forms of communication are appropriate before the client becomes completely demented, but this does not take priority over safety precautions. The client does not need an exercise regimen as the client is already hyperactive, and seizures do not occur. DIF: Analysis/Analyzing REF: p. 1908 OBJ: Intervention MSC: Safe, Effective Care Environment Safety and Infection Control-Injury Prevention)
The nurse is caring for a patient diagnosed with Parkinson's disease. The patient is having increasing problems with rising from the sitting to the standing position. What should the nurse suggest to the patient to use that will aid in getting from the sitting to the standing position as well as aid in improving bowel elimination? A)Use of a bedpan B)Use of a raised toilet seat C)Sitting quietly on the toilet every 2 hours D)Following the outlined bowel program
B (Feedback: A raised toilet seat is useful, because the patient has difficulty in moving from a standing to a sitting position. A handicapped toilet is not high enough and will not aid in improving bowel elimination. Sitting quietly on the toilet every 2 hours will not aid in getting from the sitting to standing position; neither will following the outlined bowel program.)
The clinic nurse caring for a patient with Parkinson's disease notes that the patient has been taking levodopa and carbidopa (Sinemet) for 7 years. For what common side effect of Sinemet would the nurse assesses this patient? A)Pruritus B)Dyskinesia C)Lactose intolerance D)Diarrhea
B (Feedback: Within 5 to 10 years of taking levodopa, most patients develop a response to the medication characterized by dyskinesia (abnormal involuntary movements). Another potential complication of long-term dopaminergic medication use is neuroleptic malignant syndrome characterized by severe rigidity, stupor, and hyperthermia. Side effects of long-term Sinemet therapy are not pruritus, lactose intolerance, or diarrhea.)
Health promotion activities the nurse could suggest to a community group for Huntington's disease include a. Eating foods high in omega-3 fatty acids. b. genetic screening for high-risk individuals. c. limiting exposure to heavy metals. d. taking 400 International Units of vitamin E daily.
B (Huntington's disease is inherited in an autosomal-dominant pattern. Genetic testing is available to families in which a member has Huntington's disease. The availability of the testing has created some ethical conflicts. DIF: Application/Applying REF: p. 1908 OBJ: Intervention MSC: Health Promotion and Maintenance Prevention and/or Early Detection of Health Problems-Health Screening)
The nurse explains that the pathology of Huntington's disease involves a. a decrease in the neurotransmitter norepinephrine. b. an excess of the neurotransmitter dopamine. c. destruction of white matter in the brain. d. formation of neurofibrillary tangles and plaques.
B (The degeneration of the caudate nucleus leads to a reduction in several neurotransmitters, including gamma-aminobutyric acid, acetylcholine, substance P, and metenkephalin, and their synthetic enzymes. This change leaves relatively higher concentrations of the other neurotransmitters, dopamine and norepinephrine. DIF: Comprehension/Understanding REF: p. 1908 OBJ: Intervention MSC: Physiological Integrity Physiological Adaptation-Pathophysiology)
Nursing interventions to support the family caring for a client with Alzheimer's disease include (Select all that apply) a. encouraging emotion-focused coping mechanisms. b. helping the family identify safety concerns and modifying the home. c. showing the family how to deal with behavioral problems. d. teaching the family alternative communication techniques.
B, C, D (Research has shown that interventions that focus on communication techniques, behavioral strategies, and environmental modifications improved the quality of life of the caregivers. Emotion-based coping styles are associated with grieving, worrying, and self-accusation and are not as effective as problem-based coping styles. DIF: Application/Applying REF: p. 1901 OBJ: Intervention MSC: Psychosocial Integrity Coping and Adaptation-Quality of Life)
The nurse would suggest to the family of a client who is in the moderate stages of AD and is being cared for in the home to (Select all that apply) a. assess orientation hourly by hiring a sitter if necessary. b. disable the stove but find ways for the client to participate in meal preparation. c. have the client wear an identification badge. d. move knickknacks to the middle of tables. e. secure the environment with a fence so the client cannot leave the home.
B, C, D, E (To provide for the AD client's safety at home, the nurse could suggest several solutions: moving knickknacks to the middle of tables so the edges can be used for balance, blocking off unsafe areas, disabling stoves, removing rugs and runners, installing grab bars in the bathroom, obtaining bedside commodes and hand-held showers, and securing the environment so the client can wander safely. See the Bridge to Home Health Care feature Safety Solutions for People with Alzheimer's Disease for more ideas. DIF: Analysis/Analyzing REF: p. 1900 OBJ: Intervention MSC: Safe, Effective Care Environment Safety and Infection Control-Home Safety)
A 73-year-old patient with Parkinson's disease has a nursing diagnosis of impaired physical mobility related to bradykinesia. Which action will the nurse include in the plan of care? a. Instruct the patient in activities that can be done while lying or sitting. b. Suggest that the patient rock from side to side to initiate leg movement. c. Have the patient take small steps in a straight line directly in front of the feet. d. Teach the patient to keep the feet in contact with the floor and slide them forward.
B. Rocking the body from side to side stimulates balance and improves mobility. The patient will be encouraged to continue exercising because this will maintain functional abilities. Maintaining a wide base of support will help with balance. The patient should lift the feet and avoid a shuffling gait.
When a 74-year-old patient is seen in the health clinic with new development of a stooped posture, shuffling gait, and pill rolling-type tremor, the nurse will anticipate teaching the patient about a. oral corticosteroids. b. antiparkinsonian drugs. c. magnetic resonance imaging (MRI). d. electroencephalogram (EEG) testing.
B. The diagnosis of Parkinson's is made when two of the three characteristic manifestations of tremor, rigidity, and bradykinesia are present. The confirmation of the diagnosis is made on the basis of improvement when antiparkinsonian drugs are administered. This patient has symptoms of tremor and bradykinesia. The next anticipated step will be treatment with medications. MRI and EEG are not useful in diagnosing Parkinson's disease, and corticosteroid therapy is not used to treat it.
A client is assessed as being in the mild stage of Alzheimer's disease (AD). The nurse recognizes the complaint made by the client's family that is most closely related to the diagnosis is that the client a."has difficulty using simple things, such as her toothbrush or comb." b."seems to have lost control over her bowels." c."seems indifferent about things she used to care about." d."uses words in the wrong context."
C (A common clinical manifestation of mild AD would include indifference or apathy. Other changes in mild AD are memory disturbances, impaired judgment and problem- solving skills, confusion, taking longer to do routine tasks, inability to adapt to new situations, and becoming irritable or suspicious. The inability to use familiar objects appears in the moderate stage. Incontinence is occasional in the moderate stage and frequent in the severe stage. Using words in the wrong context is moderate AD. DIF: Application/Applying REF: p. 1895 OBJ: Assessment MSC: Physiological Integrity Physiological Adaptation-Pathophysiology)
A patient with Parkinson's disease is undergoing a swallowing assessment because she has recently developed adventitious lung sounds. The patient's nutritional needs should be met by what method? A)Total parenteral nutrition (TPN) B)Provision of a low-residue diet C)Semisolid food with thick liquids D)Minced foods and a fluid restriction
C (Feedback: A semisolid diet with thick liquids is easier for a patient with swallowing difficulties to consume than is a solid diet. Low-residue foods and fluid restriction are unnecessary and counterproductive to the patient's nutritional status. The patient's status does not warrant TPN.)
A patient, brought to the clinic by his wife and son, is diagnosed with Huntington disease. When providing anticipatory guidance, the nurse should address the future possibility of what effect of Huntington disease? A)Metastasis B)Risk for stroke C)Emotional and personality changes D)Pathologic bone fractures
C (Feedback: Huntington disease causes profound changes to personality and behavior. It is a nonmalignant disease and stroke is not a central risk. The disease is not associated with pathologic bone fractures.)
A patient with Parkinson's disease is experiencing episodes of constipation that are becoming increasingly frequent and severe. The patient states that he has been achieving relief for the past few weeks by using OTC laxatives. How should the nurse respond? A)"It's important to drink plenty of fluids while you're taking laxatives." B)"Make sure that you supplement your laxatives with a nutritious diet." C)"Let's explore other options, because laxatives can have side effects and create dependency." D)"You should ideally be using herbal remedies rather than medications to promote bowel function.
C (Feedback: Laxatives should be avoided in patients with Parkinson's disease due to the risk of adverse effects and dependence. Herbal bowel remedies are not necessarily less risky.)
The most helpful intervention by the nurse for a client experiencing a parkinsonian crisis would be to a.administer oxygen by nasal catheter. b.give the client IV fluids that contain potassium. c.place the client in a nonstimulating environment. d.provide the client with foods high in calcium.
C (Occasionally, clients with PD experience a parkinsonian crisis as a result of emotional trauma or sudden or inadvertent withdrawal of anti-parkinsonian medication. Severe exacerbation of tremor, rigidity, and bradykinesia, accompanied by acute anxiety, sweating, tachycardia, and hyperpnea occur. The client should be placed in a quiet room with subdued lighting. Medical treatment may include barbiturates in addition to anti-parkinsonian drugs. DIF: Application/Applying REF: p. 1905 OBJ: Intervention MSC: Physiological Integrity Basic Care and Comfort-Rest and Sleep)
A client is receiving donepezil (Aricept) for moderate Alzheimer's disease. The nurse would assess that teaching goals for this medication have been met when the client's spouse says a. "Aricept works by blocking oxygen free radicals in the brain." b. " Depression has been the worst part so I'm glad this pill will control it." c. "I'm anxious to see how much improvement the medications allows." d. "This medicine will prevent further deterioration in condition."
C (Several medications are used to retain Ach in the neurojunctions of the brain. They can have small but noticeable effects and may temporarily lead to improvements. However, no drug stops the progression of AD. Aricept does not work to block oxygen free radical action, however; some studies show that alpha-tocopherol (vitamin E) and selegiline have this action. Aricept does not work on depression; often clients with AD also need antidepressants. DIF: Application/Applying REF: p. 1897 OBJ: Intervention MSC: Physiological Integrity Physiological Adaptation-Pharmacological and Parenteral Therapies-Pharmacological Agents/Actions)
A patient has just been diagnosed with Parkinson's disease and the nurse is planning the patient's subsequent care for the home setting. What nursing diagnosis should the nurse address when educating the patient's family? A)Risk for infection B)Impaired spontaneous ventilation C)Unilateral neglect D)Risk for injury
D (Feedback: Individuals with Parkinson's disease face a significant risk for injury related to the effects of dyskinesia. Unilateral neglect is not characteristic of the disease, which affects both sides of the body. Parkinson's disease does not directly constitute a risk for infection or impaired respiration.)
A patient who was diagnosed with Parkinson's disease several months ago recently began treatment with levodopa-carbidopa. The patient and his family are excited that he has experienced significant symptom relief. The nurse should be aware of what implication of the patient's medication regimen? A)The patient is in a "honeymoon period" when adverse effects of levodopa-carbidopa are not yet evident. B)Benefits of levodopa-carbidopa do not peak until 6 to 9 months after the initiation of treatment. C)The patient's temporary improvement in status is likely unrelated to levodopa-carbidopa. D)Benefits of levodopa-carbidopa often diminish after 1 or 2 years of treatment.
D (Feedback: The beneficial effects of levodopa therapy are most pronounced in the first year or two of treatment. Benefits begin to wane and adverse effects become more severe over time. However, a "honeymoon period" of treatment is not known.)
A client with AD begins to tell the nurse about his early-married life. The nurse should a. assess orientation to time and place. b. distract the client from this activity. c. encourage the client to talk about recent memories. d. listen to his stories
D (Memory impairment occurs in all stages of AD and the nurse must use interventions that are designed to enhance memory. Because clients' long-term memory is retained longer than their short-term memory, allow them to reminisce about past experiences. Reminiscing is a normal activity; there is no need to assess orientation. Distracting the client not only will negatively impact memory but also may agitate the client. Recent memory is impaired, so encouraging the client to discuss recent events that he/she may not remember may also be agitating. DIF: Application/Applying REF: p. 1899 OBJ: Intervention MSC: Psychosocial Integrity Coping and Adaptation-Therapeutic Interactions)
You are the nurse caring for a patient diagnosed with Huntington's disease who has been ad-mitted to the hospital for treatment of malnutrition. What independent nursing action should be implemented in the patient's plan of care? A) Firmly redirect the patient's head when feeding. B) Administer phenothiazines after each meal as ordered. C) Encourage the patient to keep his or her feeding area clean. D) Apply deep, gentle pressure around the patient's mouth to aid swallowing.
D (Nursing interventions for a patient who has inadequate nutritional intake should include the following: Apply deep gentle pressure around the patient's mouth to assist with swallowing, and administer phenothiazines prior to the patient's meal as ordered. The nurse should dis-regard the mess of the feeding area and treat the person with dignity. Stiffness and turning away by the patient during feeding are uncontrollable choreiform movements and should not be interrupted.)
Which nursing diagnosis is of highest priority for a patient with Parkinson's disease who is unable to move the facial muscles? a. Activity intolerance b. Self-care deficit: toileting c. Ineffective self-health management d. Imbalanced nutrition: less than body requirements
D. The data about the patient indicate that poor nutrition will be a concern because of decreased swallowing. The other diagnoses may also be appropriate for a patient with Parkinson's disease, but the data do not indicate that they are current problems for this patient.
A 76-year-old patient is being treated with carbidopa/levodopa (Sinemet) for Parkinson's disease. Which information is most important for the nurse to report to the health care provider? a. Shuffling gait b. Tremor at rest c. Cogwheel rigidity of limbs d. Uncontrolled head movement
D. Dyskinesia is an adverse effect of the Sinemet, indicating a need for a change in medication or decrease in dose. The other findings are typical with Parkinson's disease.